Depression is one of the types of mental disorders of a person. The world's population seriously underestimates depression, although the International Classification of Diseases (ICD 2010) contains a description of depressive episodes as diseases. Experts in the field of psychiatry say that in the modern world, mortality statistics in a state of depression can argue with indicators of cardiovascular diseases.
Depression is really a disease that has only a small fraction of the total with a banal bad mood. Unfortunately, people confuse these two concepts, devaluing the essence of depression as a disease that can be fatal.
Forms of depression
A depressive condition has specific symptoms called the depressive triad. The triad implies, firstly, a decrease and inhibition of motor activity, secondly, a decrease in mood on an ongoing basis, and, thirdly, a disturbance in thinking. Forms of depression physicians call its varieties, depending on the nature of the course, causes and external manifestations.
Clinical or DMD
A major depressive disorder, in contrast to the simpler forms of the disease, is a whole complex of symptoms and their triggering mechanisms. This form is also called acute, since the manifestations of the disease are not only diverse, but also quite clearly defined in the affected. Interestingly, MDD is not necessarily accompanied by bad mood and depression, it happens in the form of masked depression.
ICD-2010 does not consider a major depressive disorder as a separate disease, in contrast to the American counterpart, the Diagnostic and Statistical Manual of Mental Disorders, where the disease is allocated a separate classification category.
MDD can be mild, moderate or severe, with psychotic symptoms, in full or partial remission. The patient may have this disease if of the 9 factors listed below he has at least 5 present:
- depressed and depressed mood;
- changes in appetite, sudden loss or weight gain for no apparent reason;
- hypersomnia or insomnia;
- loss of pleasure from any activity that previously caused positive emotions, a strong decline in interest in life activity;
- feeling excessive guilt and worthlessness;
- loss of energy, chronic fatigue;
- reduced ability to mental activity and concentration;
- psychomotor agitation or slowing down of mental and motor activity;
- the emergence of thoughts about suicide in an abstract form, or planning suicide, suicide attempts.
It is also important to monitor the stability and duration of the presence of these symptoms - they should be observed for 2 weeks in a row or more, every day or almost. At least one symptom should be associated with a decrease in mood, depression and loss of interest in life.
In addition, patients with DMD systematically distort the internal perception of events, due to which everything that happens to them aggravates the thoughts of their worthlessness, and also contributes to strengthening the negative views on the world around us and the estimated future. The patient has a distortion and distortions of consciousness in the form of categorical, random conclusions, thinking in the style of "all or nothing", selective abstraction and exaggeration.
This type of depression is characterized by instability of the state, when a person constantly changes from depressed and depressed mood to hyperactivity and intense mood elevation. The patient is not able to control his own emotions, and in everyday life they have a calm and shy character. In periods of aggravation, on the contrary, the struck shows a fanatical attitude, prone to religiosity.
Manic depression is equally common among men and women, however, the female half of the patients are more likely to develop the depressive phase.
Changing the patient's condition can occur with any time period - every week, month or year. During remission, a person feels relatively calm and balanced, he may have drowsiness and general weakness.
For the first time the disease makes itself felt at the age of 35 years. As for the debut of manic form in childhood, it is accompanied by hyperactivity and attention deficit disorder.
There are several factors contributing to the development of pathology, including:
- genetic predisposition;
- biochemical pathologies in the brain;
- endocrine disruption;
- infectious brain damage;
- acute and chronic stress.
Manic depression is characterized by seasonality of manifestations - this means that the patient usually suffers from its manifestations in spring and autumn. When the disease is just beginning to develop, the affected person has not very noticeable changes in mood. With the onset of manic stage, the patient manifests elevated mood, hyperactivity and fanaticism. A person experiences a sharp tides of happiness, love for the whole world, he is over-excited. Against this background, there is a sharp uplift and surge of energy, the patient feels that he can do anything. During such a period a person is able to do a lot of thoughtless actions and set up impossible plans.
Internal clips and complexes temporarily fade into the background, the patient emancipates and begins an active sex life, gets a large number of acquaintances. Astonished, he moves a lot, he says, he discovers unusual talents and feels incredibly inventive.
The patient may admit that his language literally does not keep pace with his thoughts. During the active manic stage, it is difficult for the patient to concentrate on the little things, he is fussy and inconsiderate, intrusive and extremely intolerant towards others. In this case, his own person, he feels undervalued, misunderstood, because of what conflicts arise with his relatives from time to time.
A huge number of cases started by the patient is inclined not to finish, throw in the middle. The manic stage, among other things, is dangerous because at this time the patient becomes prone to smoking, drinking alcohol and even narcotic substances. At the same time, the patient's need for sleep and food decreases, and the perception of time can even be distorted. The perception of danger and the instinct of self-preservation are dulled, so the patient is prone to trauma.
Against the background of increased activity, the affected person begins to attend circles, courses, trainings, he is drawn to development, he is trying to learn new things. The speech of the patient in the manic stage differs by expressiveness, volume, intensity. He is inclined to discuss and condemn everything around. Often in the manic stage the patient changes the image, hairstyle, style of clothes.
Against the background of the presence of a positive view to the patient, it seems that he is beginning a new stage in life. Emotional upheaval is accompanied by the appearance of incorrect conclusions and judgments.
After some time, a manic mood boost is replaced by a decline - the depressive phase. In general, the patient feels sadness, fatigue, it seems to him that life does not make sense. For days on end, a person may not leave the house, he does not need to communicate with people. Women are very prone to crying at this time.
In general, patients show a pessimistic view of the future. Their mental reactions, movements are slow. For some, it is common to blame others for their own unfulfilled plans. It is during this period that thoughts of suicide appear.
Ordinary activities no longer arouse interest, and what previously pleased, does not attract more. Against the background of general mental instability, a feeling of hopelessness and helplessness appears. The patient is confused in his own thoughts, he becomes irritable, sometimes aggressive, and can not concentrate on the little things. Every day there is a great need for rest and sleep, the patient can literally sleep all day, as he feels unusually tired.
Many women in the depressed phase tend to seize their depressive mood with a lot of junk food, which is why they start to gain weight. Other patients, on the contrary, suffer from anorexia, bulimia.
Normal night sleep becomes a rarity - the patient cannot fall asleep, and if he falls asleep, sleep is superficial and does not bring the body full relaxation and rest. This increases anxiety, suspicion, and expectation of negative events. The amazed person does not smile, his face is tense, sometimes he looks as if he is completely immersed in himself and his thoughts. The other extreme is when the patient runs and rushes about, cries, screams and calls for help.
Recurrent depressive disorder - this is how repeated episodes and seizures of depression are called. This form proceeds cyclically, with constant repetitions of typical phases. That is, depressive episodes alternately subside, then amplify.
Depression as a whole has a tendency to protracted course, but if the episode tends to recur in the patient's life, this form can already be considered recurrent.
The likelihood of such a form - about 75-80%. It is in such a number of cases a month or two after the improvement a second episode occurs. Recurrent depression in about half of the patients goes into bipolar affective disorder after 2-4 repeated deterioration. In addition, the form is dangerous because it can turn into a chronic course that accompanies the patient throughout his life. In difficult cases, causes a loss of capacity, the inability to live normally in society, create a family.
This type of disease is also called dysthymia. Interestingly, chronic depression is considered a mild form of the course. Symptoms may occur for a year or two or more. People with such a diagnosis usually live normally in society, but feel absolutely miserable.
With regard to the causes of appearance, specialists in psychiatry and psychology did not come to unambiguous conclusions about what provokes its appearance. It is believed that there is a link between impaired serotonin production in the brain and the onset of the chronic form. In addition, the development of the disease contribute to chronic stress, taking certain medications, chronic diseases and disorder in your personal life.
The course of the disease is characterized by the fact that the patient has such states for a long time and not too vividly:
- constant feeling of emptiness and sadness;
- trouble sleeping and early awakening;
- guilt, hopelessness, helplessness;
- loss of interest in yourself and others;
- increased fatigue;
- distraction of attention;
- slowness of physical and mental reactions;
- persistent headache, joint pain, digestive problems that are difficult to treat;
- suicidal thoughts.
If there are 6-7 symptoms persistently present, the doctor may diagnose chronic depression. In the case of dysthymia, the symptoms do not have a pronounced picture, but against the background of the normal state of a healthy person, it is quite traceable.
It is important for the doctor to determine that such manifestations are not signs of drug or alcohol dependence, problems with the endocrine system.
The reason for going to the doctor is the feeling of depression and depressed mood, which does not pass within two to three weeks. This does not mean that a person is depressed, but in the case of this disease, it is better to be safe.
The name of the form fully reflects the peculiarity of its course - in this case, depression hides its typical symptoms behind other manifestations that are characteristic of other diseases. For example, the patient is worried about unexplained pains in different parts of the body, jumps in blood pressure, general weakness, anxiety, but he doesn’t even realize that the cause of these pathologies is depression.
There are several groups of so-called masks behind which a masked depression can hide.
One of the types of masks psychopathological disorders - anxious phobic mask. The patient feels unexplained attacks of anxiety, fear of appearing in public places, fear of death, hypochondriacal phobias, fear of loneliness - the list can go on and on. These conditions are not always a manifestation of depression. If a person has phobias for a long time, he can cope with them and does not feel much discomfort, then the problem is not so serious. If the attacks of phobias have appeared recently, are not amenable to control and interfere with the normal existence in society, then you should consult a doctor.
The obsession mask is determined by the fact that the actions of the patient become obsessive, even with the awareness of the absurdity of such actions. A person is not able to control his actions - until he performs a specific sequence, the number of times he needs, he cannot calm down.
Hypochondria - a feeling of heightened suspiciousness, a sense of the presence of the disease, confidence that a person has a disease. In addition to the fact that hypochondria is considered an independent mental disorder, it can also be a mask of depression.
Neurasthenia is characterized as irritability, irritability and emotional instability against the background of a general weakness of a physical nature, rapid exhaustion.
Physiological disorders can also be masks of depression, for example, insomnia, problems with falling asleep, increased sleepiness or vice versa, lack of sleep, excessively early waking up, and stable intermittent sleep.
Endocrine disorders, autonomic disorders and abnormalities in the work of internal organs - depression can also manifest itself in the form of dizziness, vegetative-vascular dystonia, psychosomatic disorders, drops in blood pressure, fainting, bouts of gluttony and bulimia, skin diseases, disorders of the chair, menstrual disorders in women .
Pain of unknown etiology - the most common type of manifestation of masked depression. Pains in the heart, head, joints, muscles, headache, pain in the intercostal, facial and trigeminal nerves, appear suddenly in the back, for no apparent reason, are intense.
Depression masks may also include pathological changes in character, pronounced antisocial behavior, abuse of alcohol, tobacco, drug use, increased impulsivity, conflict, outbreaks of aggression.
Masked depression sometimes hides behind hysterical reactions and seizures of heightened tearfulness, touchiness, the desire to attract attention.
Also called seasonal affective disorder. Doctors refer this form to the clarifying type of major depressive disorder. Seasonal depression is characterized by a period of occurrence - at about the same time every year. The most common and studied type is winter. Summer type is more rare.The winter form begins in autumn, lasts until April-May. Summer depression begins in early summer and ends in mid-autumn.
The debut of seasonal depression occurs between the ages of 15 and 55 (usually in people between 20 and 30 years). With age, the chances of development are reduced. Seasonal depression affects women more often. Some affected people feel only relieved symptoms of the disease - irritability, fussiness, nervousness, depressed mood and inability to concentrate. Other patients experience depression more intensely, and its manifestations strongly influence the lifestyle and its behavior.
Predisposition to the disease is present in people whose relatives have a history of diagnosed episodes of ATS, as well as the population of the regions where the duration of the winter day is very short, there is a lack of sunlight.
In the northern latitudes of people during the transition to the winter season may be present:
- depressed mood;
- chronic fatigue;
- night sleep redundancy;
- eating disorders.
In this case, we can talk about seasonal affective disorder.
Sub-syndromic type of the disease belongs to the subspecies of seasonal depression. At the end of the winter season, such patients usually undergo persistent remission.
The causes of seasonal depression are studied by physicians. It is theoretically believed that the etiology of the seasonal form is associated with the effect on the person of changes in the circadian rhythms, the so-called “internal biological clock” of man. Together with impaired production and functioning of neurotransmitters in the form of serotonin, dopamine and norepinephrine, these factors can lead to the appearance of a seasonal form of pathology. There is also a theory about the influence of climatic factors on the development of seasonal depression.
- depressed for 2 weeks or more;
- lack of interest in themselves, around people and events;
- low mood;
- inexplicable guilt, anxiety;
- difficulty concentrating;
- low self-esteem, self-flagellation;
- rapid fatigue, reduced working capacity;
- the desire to spend more time alone, avoiding contact with people;
- suicidal thoughts;
- eating disorders.
The emergence and development mechanism
All the reasons that can provoke the appearance of depression in humans, doctors divide into internal and external.
Internal causes of depression are divided into somatogenic and endogenous. Somatogenic depression develops on the background of severe somatic diseases, as well as pathologies of the brain. The formation of an endogenous type of depression, to date, has not been fully studied.
External causes are called psychogenic or reactive. We are talking about depressions that were provoked by traumatic situations, severe psychological trauma, for example, loss of a loved one, divorce with a spouse, loss of work. If chronic diseases and hormonal disturbances are imposed on difficult life circumstances, depression can develop into a severe form.
Endogenous depressive episodes account for about 7% of all diagnosed cases of the disease. The reasons are studied by doctors, but most experts agree that the main role here is given to genetic predisposition, inheritance of pathological genes that are responsible for increased emotional sensitivity. The mechanism of development is based on the internal features of a person’s personality, for example, traits of character and susceptibility. The impetus for the development of the disease can be both external and internal factors.
The most common form of depression that occurs in a person in response to difficult life situations, psychological trauma, loss of loved ones. It is provoked by strong and severe external factors and circumstances.
Depression is a disease with a specific clinical picture of the course, which is characterized by signs and symptoms. Differential diagnosis of various forms of the disease occurs precisely on the basis of distinctive features and symptoms. The symptoms of the disease are divided into emotional, physiological, behavioral and mental.
Emotional signs imply the presence of inexplicable melancholy, feelings of anxiety, fear, depression, personal insignificance, guilt, expectation of misfortune, self-incrimination. The patient feels a feeling of irritability, a steady decline in self-esteem and self-confidence.
Physiological signs include impaired appetite, digestive processes, sleep disorders, severe fatigue and disability.
Among the behavioral signs - the desire for loneliness, passivity, loss of interest to others, a tendency to alcoholism and taking psychotropic substances.
Mental signs are the appearance of difficulties with concentration, the presence of predominantly negative thoughts, a pessimistic view of the future, difficulty in making decisions, suicidal attempts.
As for the symptoms, they can be the basis for the diagnosis of “depressive disorder”. ICD 2010 divides all symptoms into major and minor. The main signs of depression (depressive triad): persistent anhedonia - loss of interest in previously enjoyable activities; depressed mood, which lasts more than 2 weeks, and does not depend on external factors; persistent feeling of fatigue lasting a month or more.
- guilt, fear, worthlessness;
- inability to make decisions, loss of concentration;
- suicidal thoughts;
- low self-esteem;
- increased or decreased appetite;
- pronounced sleep disorders: insomnia or increased sleepiness.
If there are 2 main and 3 additional symptoms in a patient, the psychiatrist makes an appropriate diagnosis.
Degrees of severity
Depending on how deeply affected the mental and physical condition of the patient, doctors diagnose him with mild, moderate or severe form of depression. However, it should be noted that such a division is conditional, and largely depends on the subjective perception by the patient of their condition.
Despite the seemingly frivolous title, a mild degree of depression is just as dangerous a disease as a serious one, since without proper treatment, it can self-extinguish or go into a chronic or severe condition.
The characteristic state of mild depression is a stable bad mood and a feeling of waiting for failure. A person loses self-confidence, ceases to hope for their own strength and success.
Often with mild depression, the patient has problems in communicating with others, they are quickly bored with communication, the conversation causes tension and a desire to distance themselves. Activity and initiative in the dialogue from such a person are absent. In the process of communication, patients feel uncomfortable, they are nervous, looking for hidden negative overtones in what was said. In addition, a light current is accompanied by flashes of aggression and anger more often than more severe forms. Such people more often than others are irritated, tend to raise their voice.
The astonished feels anhedonia in a light degree - occupations that previously fascinated him are no longer of such interest. Regardless of what steps and changes will occur in the life of a depressed patient, the state of dissatisfaction and lack of interest does not go away. Such patients are chronically unsatisfied with their own lives, they think that they are underestimated at work and in the family. On the basis of this form of the disease, other, more serious behavioral and psychological disorders - phobias, addictions, eating disorders often appear.
The next level of the disease depth is moderate, that is, medium. Symptoms are similar to the manifestations of the mild form, but, accordingly, they appear more strongly and almost constantly. The patient is difficult to pull himself together, to gather strength and thoughts. At the same time, he feels sadness, longing, lack of energy, lack of interest in the world around him. Guilt feelings and their own low self-esteem make it difficult to fully communicate with loved ones. Thoughts and activities that previously brought joy, do not cause a positive response in the soul. It becomes difficult to concentrate on work, work, family or reading. Making decisions on everyday issues requires an incredible amount of effort. In this case, the patient feels a constant desire for solitude, lack of desire to communicate with people.
With moderate depression, a person has a sharp change of mood during the day, so-called daily fluctuations, for example, in the morning the patient feels disgustingly unhappy, and in the evening his state of health returns to normal. After sleep, one does not feel cheerful, like after a good rest. Against the background of a moderate degree of the disease, a decrease in appetite, loss of weight and sexual desire.
The deepest level of the disease is severe. Such depression is also called psychotic, in which delusional ideas of guilt, accusation, self-destruction, and even hallucinations with consonant content join the main symptoms. All previous symptoms of depression are aggravated, melancholic arousal is added.
In its development, the disease goes through several stages, namely, 5 stages of formation, each of which follows from the previous one.
The onset of depression is marked by the appearance of denial. The person continues to lead a habitual way of life, pretending that nothing is happening. If there is a loss of a close relative, the person continues to talk about him in the present tense, stores his things and photos, prepares his favorite dishes. Thus, the victim denies the circumstances in real life, denies the fact of their occurrence. He has an unusually good mood, an increase in the duration of sleep and the need for food, bouts of uncontrollable laughter and fun. So begins the first round of development of depressive disorder.
The next stage of experiencing grief and problems is the appearance of anger, into which the denial of the problem is transformed. During this period, a person realizes that there is no point in denying what happened next. To pour out his grief, he begins to look for the guilty, splash out emotions on others. The character manifests irritability, tearfulness, and all this against the backdrop of frequent mood swings.
Anger is a very expensive emotion that quickly depletes a person and comes to naught. Gradually, the patient begins to listen to relatives and recommendations of the doctor. In fact, this stage is the beginning of the patient’s awareness of his problem when a person feels the desire to get rid of it. At this time, there is a lull in behavior, agreement with the actions of others, immersion of a person in a thoughtful state. There is confidence that, subject to compliance with the rules and requirements of treatment, the situation may change for the better.
Then comes the state of the depression itself as it is. Awareness of the problem is noted, on this background a feeling of despair and pain, anguish, fear and hopelessness is formed. In addition, there are typical symptoms of depressive disorder - problems with sleep, slowness, lethargy and apathy, lack of joy from life and favorite activities, depression. The patient notices suicidal thoughts, lack of an optimistic outlook on life. In difficult cases, from thoughts about suicide, a person moves to actions.
The last, final stage of the development of the disease - the adoption of their condition. Time passes and there is an awareness that life does not stand still. Patients are looking for comfort in new activities and acquaintances, in children and their favorite business. It should be noted that such a state does not always occur, moreover, without appropriate treatment, therapy, medication, taking will not last long and will be replaced by a new round of depression. In general, acceptance cannot be identified with recovery, as it is rather a stage of spontaneous attenuation of the symptoms of the disease.
The stage is manifested by a return to the usual rhythm of life, a desire to meet, travel and learn new things, the appearance of high spirits.
Features of the course of depression
Depressive syndrome is a pathology that has certain features of the course in the male and female body. In this case, a person develops a specific type of mental disorder.
In men, depression is less common than in women. However, we should not miss the moment that men in general are not so willing to seek medical help, even if they feel physical discomfort. And such symptoms as bad mood, depression, or sleep disturbances in general few of the stronger sex will make a doctor visit.
Nevertheless, the male brain has its own peculiarities of perception, a tendency towards rationality and abstract thinking, more rapid adaptability to the factors of the surrounding world. This does not mean that men are not threatened with depression, but their tendency to fall into this state is not as pronounced as in women. Because of the reluctance to consult a doctor, men often diagnose advanced cases of the disease.
The reasons why a depressive disorder is formed in a man are quite diverse:
- conflicts in the family and at work;
- dissatisfaction with their own lives;
- problems in the intimate sphere;
- chronic and acute stress;
- health problems, chronic diseases;
- financial hardship and job loss;
- middle age crisis;
- disorders of the endocrine system, brain, hormonal disorders;
- tumors and brain injuries.
Features of the course of the disease in men due to their style of thinking and perception of the world. Men are more prone to latent, suddenly bursting aggression, irritability and outbursts of anger. Most of the time the patient is in a depressed state, periodically interrupting his attacks of aggression towards others. Like in women, the male half of the diseased has thoughts of suicide, often quite concrete, in the form of a plan. Especially this trend is observed in patients aged 18-35 years.
A distinctive feature of the "male" trend is the problem of potency, due to which interest in sex life as a whole is lost, the sense of worthlessness and inferiority is exacerbated. Moreover, such symptoms are more characteristic of men of the so-called middle age.
On the background of a depressive disorder, problems of a physiological nature appear: shortness of breath, pain of unexplained nature, jumps in blood pressure, arrhythmia, headaches and unpleasant feelings in the back. A man in this state is inclined to withdraw into himself, to avoid contact with friends and family.
Depression in women also has features of manifestation, as the female body during life is faced with such conditions and periods as menopause, pregnancy, childbirth.
During pregnancy and after childbirth
During this period, the female organism undergoes a thorough restructuring of the functioning of the neuroendocrine system, therefore, physicians separately take out the prenatal depression syndrome for research. In this case, we are talking about a steady, constant and prolonged (more than 2 weeks) state of anxiety, pessimism and bad mood.The course of depression in a pregnant woman can take on varying degrees of severity, from mild headache and loss of appetite to the appearance of obsessive-type suicidal thoughts.
The reasons for the formation of a depressive disorder are based on the presence of a predisposition to the disease before the onset of pregnancy, and also overlap with a hereditary predisposition. In addition, external factors, such as conflicts with loved ones, stress due to lifestyle changes, problems with work and finances also undermine the mental health of women.
Interestingly, despite these features, depression in pregnant women is less common than in other groups of patients, but it is in future mothers that this disease leads to the most dire health consequences - not only her, but also the baby.
At different stages of pregnancy, the disease occurs in various forms. In the first trimester, women experience an initial change in behavior and mental perception associated with hormonal adjustment.
The second trimester affects the female body in a different way - during this period, the woman has already accepted the fact that her life is changing forever due to the appearance of a child. Habitual lifestyle needs to be reviewed and changed.
A pregnant woman constantly feels a deterioration of well-being associated with her condition - back pain, insomnia, weight gain, constant need and urge to urinate.
The most psychologically difficult period for a woman is the third and final trimester. At this time, the disease manifests itself in full force. A woman feels the fear of childbirth, fear for her future and her baby, as well as the burden of responsibility. At the same time, a bad mood takes a protracted nature, a woman constantly feels tired because of her own fullness, awkwardness and a big belly.
The duration of prenatal depression is from one to nine months. In difficult cases, the prenatal form after birth immediately flows into the postpartum. This condition is especially dangerous for women and children, and requires mandatory treatment.
Postpartum depression is a disease that affects about 15% of women after giving birth. In half of the cases, the disease takes on severe forms. During the first three months of a new condition, a woman is especially susceptible to the development of a depressive disorder.
The risk group includes those who previously experienced depressive episodes, women with mental pathologies of a different kind, as well as those who have a genetic predisposition to neurological diseases.
In addition, the disease threatens women, who, due to their nature, are prone to increased anxiety. If, against this background, a young mother does not receive the necessary moral and physical support from her relatives, the probability of the appearance of the disease increases dramatically.
The physiological basis of the disease is another hormonal alteration of the body, which begins after childbirth, as well as changes that occur with the body.
Among the common signs of postpartum psychopathology are:
- increased tearfulness;
- outbursts of anger and aggression;
- increased anxiety, insecurity and emptiness;
- sleep disorders;
- reduced self-esteem, hate feelings, and aversion to self and body;
- lack of interest in intimacy after 4 or more months after childbirth;
- headache and body aches;
- desire for loneliness and distance from others.
Mother's postpartum depression directly affects her health, as well as the condition of the baby, who may develop speech and mental retardation, sleep disorders.
Another difficult period in the life of a woman is menopause. During menopause, extensive endocrine changes occur in the body, accompanied by at least some mental discomfort. Not all women with menopause suffer from depression - here the factors of predisposition and lifestyle play a role. According to statistics, the disease manifests itself in 8-15% of women. All the causes of the development of depressive episodes during menopause are divided into physiological and psychological. The first group includes the destabilization of hormonal levels with an intense decrease in estrogen production. Against this background, the amount of serotonin in the body decreases.
The perception of menopause as the main stage in approaching old age, the loss of sexuality, the change in perception - this is how the psychological basis for the onset of depression is formed. The desire to preserve the former way of life, despite the changes taking place, is combined with this. Violation of the usual regime and stress cause irritability, bouts of melancholy and despondency.
There are several types of depression in menopause:
- climacteric: associated with apathy, lack of interest in others and previously loved activities. The patient disappears sexual desire, anxiety and passivity increases, there are problems with sleep;
- endogenous: pronounced pessimism, longing and apathy come to the fore, pessimistic mood, loss of appetite and insomnia can also be traced;
- Involutionary: in this case, a woman is inclined to exaggerate the severity of her health problems. The patient is disturbed by her own condition, tormented by the fear of death, she has pain of unknown origin in the whole body;
- psychogenic: characterized by strong anxiety, the presence of unpleasant and heavy thoughts, a pessimistic view of life. Self-criticism is sharply aggravated, self-esteem decreases. The condition is accompanied by problems with sleep and appetite, weight loss.
The course of the disease can take up to 3-5 years, and often turns into a chronicle.
Adolescence - the period of the formation of the personality, when the child gradually turns into an adult, he begins puberty, psychological maturation. Against this background, a teenager is experiencing natural changes in behavior - he becomes self-contained, behaves rudely and aggressively, constantly in conflict with his parents and those around him. The reason for such changes - hormonal changes. As a result of a failure in hormone production, adolescent depression may occur in a teenager.
Symptoms of the disease has a characteristic picture, the duration of at least 2-3 weeks. A teenager has the following signs of the disease:
- depressed mood;
- isolation and the desire to dismiss from contacts;
- degradation of performance;
- dominant fatigue;
- insomnia or increased sleepiness;
- irritability and aggressiveness;
- eating disorders;
- defiant behavior;
- suicidal thoughts and self-destructive behavior.
The reasons for the formation, in addition to internal changes in the body, are also external factors, such as parental abuse, conflicts and failures in communicating with the opposite sex, unsuccessful first sexual experience, indecision, problems at school, with classmates and academic performance.
The duration of the disease is from several months to 3-4 years. Without treatment, it goes into a deep degree, sometimes with anxiety and depressive disorders.
Characterized by a change in periods of remission and exacerbations. Doctors consider autumn depression as a form of exacerbation of depressive disorders, that is, the disease simply worsens with the onset of the autumn season, and in a healthy person, it is less likely to occur in the fall.
In addition, psychiatrists say that an aggravation of the latent form may occur in the fall, because of which hidden depression is also called seasonal. In a patient, as a result of the onset of a change in the weather, due to the decrease in daylight hours, the depressive state aggravates, sharp mood variability arises, and the feeling of helplessness and inferiority increases.
Depression refers to diseases that worsen the quality of life of the patient so much that he is able to cause himself harm, especially if he is actively overwhelmed by thoughts about suicide. Therefore, a visit to the doctor in such cases is mandatory, as an experienced psychiatrist can detect signs of illness, even in the early stages.
The disorder is especially characterized by gradual progression and deterioration, as well as cyclicality. The debut does not always have bright, well-marked manifestations, and is indicated only by superficial, minor changes in behavior, a decrease in vital activity. Then other signs gradually join, the so-called depressive triad develops.
Diagnosis of depression by a doctor occurs on the basis of the results of examinations, which he conducts independently or with the involvement of related specialists. It is important to determine what triggered the onset of a depressive episode.
The doctor usually starts taking a patient's history. The psychiatrist assesses and ascertains directly at the patient the possible causes of the disease, clarifies and analyzes the picture of the symptoms. Having enough experience, the doctor can diagnose even patients in a state of neglected apathy, those who refuse to make contact and communicate with the doctor.
Pathopsychological research is conducted by a clinical psychologist. Its main goal is differential diagnosis with schizoaffective disorder, neurosis and other pathologies, as well as monitoring the effectiveness of the prescribed treatment. The doctor assesses the state of memory, the concentration of the patient, collects information about the features of his thinking and emotional-volitional sphere.
In order to diagnose depression in a person, it is sometimes necessary to involve other specialists in the examination, for example, a neuropathologist and a therapist. In cases where the patient complains of unexplained pain, impaired sensitivity of the limbs, problems with the digestive process, as well as the symptoms of somatic diseases, it is very important to determine the real cause of these sensations - whether they are associated with depression, or if the patient has other diseases.
Often, the endocrinologist is connected to the diagnosis, since a depressive disorder can be associated specifically with diseases of the endocrine system.
Laboratory and instrumental examination in the diagnosis of depression is appointed if the psychiatrist is suspicious about the presence of other diseases, since the depression itself cannot be diagnosed by the results of tests or research. The patient may be prescribed tests for thyroid hormones, CT or MRI of the brain, neurotests.
There are several ways and methods of influencing a patient with a diagnosis of “depression”, and there are two main areas of treatment: psychological and drug effects.
First of all, to begin to deal with depression, you need to recognize her presence in your home country, and start talking about it, discuss your condition. First of all, we are talking about attending psychotherapy sessions, working out and pronouncing your own problems. By choosing different approaches, the psychotherapist or psychiatrist is able to help the patient to consider his own state of depression from the point of view of interest and readiness to treat it. Such sessions help to pay attention to the root cause of depression, and send forces to eliminate it.
It is important to understand that treatment of depression and communication with a physician are not capable of helping a person get rid of the causes of depression, if the problem lies, for example, in dissatisfaction with life, disorder or low self-esteem. There are also group sessions of psychotherapy that help their participants to get out of their depressive state.
The second line of treatment is medication. Unfortunately, if the symptoms of the disease are especially strong, and the patient has a risk of suicidal attempts, it is impossible to do without the use of antidepressants. All drugs in this group have their own list of side effects and contraindications, so using them alone is strictly prohibited. In most cases, it is believed that side effects are justified and bring the patient less harm than the lack of treatment with antidepressants. Basically, this group of drugs helps to improve and consolidate the results of psychotherapeutic treatment.
If the cause of depression is associated with the presence of other diseases, such as insufficient thyroid hormone production, a brain tumor, or diabetes mellitus, treatment is prescribed in accordance with the diagnosis.
In addition to traditional methods, doctors may recommend to attend acupuncture, do aerobic exercises, take herbal infusions, supplements. Often appointed vitamin and tonic complexes.
How not to fall into a mental disorder
It should be noted that recommendations on how to avoid depression and not fall into frustration in difficult life situations are of a purely general nature, and, unfortunately, do not guarantee the preservation of mental health of a person. They can be called prevention of the disease, but it must be remembered - no one is immune from depression.
Doctors, first of all, are advised to always find time to practice what brings real pleasure to a person. This moment is especially important for those who suffer from unloved work that does not bring satisfaction. Favorite hobbies are vent, a method of dealing with dissatisfaction. Planning pleasant affairs can also be considered prevention of the disease.
Listening to music, traveling, taking care of house plants or animals, underwater video filming or collecting stamps - any hobby is one of the ways to deal with stress and negative factors that attack the psyche from the outside.
The next recommendation is to maintain contact with people. You should not look for isolation, throw away your friends and spoil relations with your close ones - forced loneliness extremely negatively affects the psyche, makes it less stable. Even virtual communication in such cases is a way out of one’s own shell.
Rejection of negative thinking is a point that many people, especially those living in the post-Soviet space, are almost impossible to cope with. Unfortunately, the tense economic situation, insecurity, poverty and lack of confidence in the future lead to the fact that people are not able to abandon the negative perception and interpretation of reality. This leads to a distortion of emotional perception and thinking, as a result of which a person in principle can no longer consider any events and facts from the positive side.
One of the reasons for the development of depression is a sense of lack of fulfillment, the absence of goals in life or their unattainability (real or apparent). In any case, setting specific goals for themselves, building plans, they need to be divided into smaller steps, which are easier to achieve. In this case, the person is less threatened by procrastination and postponing the task until later. Interestingly, step-by-step planning has a positive effect on a person’s thinking and perception, so psychotherapists use a similar method to deal with depression.
Proper nutrition, stopping smoking and alcohol abuse, adding sport to your daily routine are recommendations that have already been teared, but they work, since a healthy mind can exist only in a healthy body.
Not only sports training, but also any movement, any active exercises are effective prevention of depressive disorder.
It can be tourism, walking, running, dancing or yoga - everything that does not allow a person to sit still.This is especially important in cases where depression is caused by a deep psychological trauma, a traumatic situation, for example, the loss of a loved one.
It is very important to allow yourself to relax from time to time, and also to devote enough time for a night's rest. A person who rushes through life at a tremendous speed, being constantly in a strict mode and schedule, will almost completely face, if not depression, then, at least, neuroses and overwork.
In addition to caring for their own health and the body, psychotherapists call the manifestation of caring for others an important factor in the prevention of depressive states. People who participate in activities aimed at paying attention to and caring for other people, children or animals are less susceptible to the onset of depression, because such an activity makes it possible to feel needed, in demand.
What is dangerous depression
Depression greatly undermines mental health, and creates consequences for him. In addition, the disease is directly and indirectly capable of causing harm to the physiological state of the affected, and in severe cases leads to suicide.
Doctors in their studies have determined that there is a connection between depression and the occurrence of cardiovascular diseases. In addition, the depressive state significantly complicates the healing process, and increases the risk of a heart attack.
In a state of depression, the patient often stops eating normally, begins to smoke, abuse alcohol, gain excess weight - these factors increase the risk of developing type 2 diabetes, especially in patients with a tendency to it. In addition, patients with depression are more likely to develop obesity due to malnutrition, bad habits and feelings of depression.
Depression directly leads to a decrease in mental abilities, impairment of memory and concentration, and sometimes even loss of performance. By affecting the immune system, suppressing it, a depressive disorder may accelerate the development of oncological diseases, chronic migraine.
Finally, the most dangerous “complication” of the disease is suicide. Two thirds of all suicides are committed in a state of depression. The desire to die does not always aggressively pursues the affected person, but at any time can turn into a clear plan of action.
Depressive disorder is a mental disorder that can and should be treated. The most problematic in this case is the recognition by a person of the existence of a problem that requires medical assistance, since the attitude to depression in society among the population of Eastern Europe is rather frivolous. However, given that a disorder can threaten not only the mental stability of a person, but also his life, he should not be underestimated.